This report is issued by the Administrator of the National Health Funding Pool under section 240 of the National Health Reform Act 2011.

This report is prepared on a cash basis. It shows monthly and year-to-date (YTD) National Health Reform (NHR) funding and payments for the Australian Capital Territory for February 2013 as part of the National Health Reform Agreement.

Participation in the National Health Funding Pool

In signing the National Health Reform Agreement (the Agreement), it was the intention of all states and territories that they would have the necessary legislation in place to enable them to participate in the National Health Funding Pool from 1 July 2012.

However, not all states and territories had their legislation in place by that date. As part of the transition to National Health Reform funding, arrangements were put in place whereby those states and territories received equivalent funding directly from the Commonwealth Treasury, and made payments directly from departmental bank accounts to local hospital networks (LHNs). Although these transactions were not made through state pool accounts and state managed funds, they have been included in this report (and designated as ‘notional payments’ into and out of state pool accounts and state managed funds) to enable national comparability for month and year-to-date reporting periods.

In February 2013, the Australian Capital Territory did not have their legislation in place in time to use the National Health Funding Pool, and used the transitional arrangements described. All amounts shown in the ACT report for February 2013 reflect notional payments.

Local hospital networks and National Health Reform

Under the Agreement, local hospital networks receive funding for the following public hospital services:

All admitted and non-admitted services

All emergency department services provided by a recognised emergency department

Other outpatient, mental health, sub-acute services and other services that could reasonably be considered a public hospital service.

Note: Local hospital networks also receive funding from other sources, including the Commonwealth, states and territories, and third parties for the provision of other specific functions and services outside the scope of the Agreement, for example dental services, primary care, home and community care, residential aged care and pharmaceuticals. For further information on total funding to a particular local hospital network, contact the ACT Department of Health to view the service agreement for that local hospital network.

Basis for National Health Reform payments

The basis used to determine NHR payments to local hospital networks (LHNs) in the Australian Capital Territory for February 2013 was advised by the Australian Capital Territory to be as follows:

The annual funding allocation for the ACT in 2012-13 was based on budget neutral modelling. This modelling was based on the historic cost of providing services plus cost indexation. The activity to be funded through activity based funding was projected on historic activity levels for public hospital services in the ACT, and derived through the application of the Independent Hospital Pricing Authority determination.

The payments made by the ACT Government and the Commonwealth Government in February 2013 through the ACT Local Hospital Network Directorate were net of third party revenue, and were paid on the basis of estimated ACT local hospital network activity for the month of February 2013.

Reference information

The financial information outlined in the following report is categorised as:

NHR funding – when the Commonwealth or state or territory government pays NHR funding into a state pool account or state managed fund.

NHR payments – when NHR funding deposited into a state pool account or state managed fund is paid out of the state pool account by the Administrator, or is paid out of the state managed fund by the state or territory.

Notional NHR payments – funds paid into and out of departmental bank accounts to local hospital networks that would have been transacted through the state pool account and/or state managed fund had the NHR funding arrangements been in place. Notional payments are included in 2012-13 reporting to enable national comparability for month and year-to-date reporting periods.

Transactions on the state pool account

This table shows funding paid into the ACT state pool account by the Commonwealth and the Australian Capital Territory, and payments out of the state pool account to local hospital networks, the state managed fund, and the state health department for February 2013.
All amounts shown reflect notional payments.

Note: The total amount of $43,650,974 shown in Table 1a as paid into and out of the ACT state pool account was notional payments for the month.

No payments were made from the ACT state pool account in February 2013, with payments made directly from departmental bank accounts to local hospital networks.

Following on from table 1a, this table shows the year-to-date (YTD) funding paid into the ACT state pool account by the Commonwealth and the Australian Capital Territory, and payments out of the state pool account to local hospital networks, the state managed fund, and the state health department as at February 2013.
All amounts shown reflect notional payments.

Note: The total year-to-date amount of $381,448,494 shown in Table 1b as paid into and out of the ACT state pool account, was notional year-to-date payments.

No payments were made from the ACT state pool account from July 2012 to February 2013 inclusive, with payments made directly from departmental bank accounts to local hospital networks.

Commonwealth ABF funding represents Acute admitted public, Acute admitted private, Non-admitted, and Emergency department service categories, which are funded by the Commonwealth through the state pool account and subsequently paid to local hospital networks.

Commonwealth Block funding represents Mental health, Small rural and metropolitan hospitals, Sub-acute, Teaching, training and research, and Other categories, which are funded by the Commonwealth and paid to the state managed fund.

Commonwealth Other funding represents other amounts funded by the Commonwealth, transacted through the state pool account and subsequently paid to state or territory health departments. This currently represents the Commonwealth contribution to public health.

State/territory funding represents funding contributions paid in by the Australian Capital Territory into its own state pool account, and subsequently paid to local hospital networks within the state or territory and/or to state or territory health departments.

Note: The grey shaded areas in these tables reflect that these amounts are not applicable for a particular 'paid out' column. For example, Commonwealth block funding is only paid to state managed funds and is not applicable for local hospital networks or state or territory health departments.

NHR funding and payments shown in these tables include GST where applicable.

Transactions on the state managed fund

This table shows funding paid into the ACT state managed fund by the Commonwealth and the Australian Capital Territory and payments out of the state managed fund for February 2013. All amounts shown reflect notional payments.

Following on from table 2a, this table shows the year-to-date (YTD) funding paid into the ACT state managed fund by the Commonwealth and the Australian Capital Territory and payments out of the state managed fund as at February 2013. All amounts shown reflect notional payments.

Commonwealth Block funding represents Commonwealth block funding contributions paid into the state managed fund from the state pool account, and block payments out of the state managed fund to local hospital networks and other provider organisations.

State/territory Block funding represents ACT block funding contributions into the state managed fund, and block payments out of the state managed fund to local hospital networks and other provider organisations.

Note: The grey shaded areas in these tables reflect that these block payments cannot at this stage be identified by source of funding (state, territory or Commonwealth contribution).

Total ABF (Pool) is an aggregate of both Commonwealth and state or territory NHR funding and payments for activity based funding (ABF) which is transacted through the state pool account.

Total Block (SMF) is an aggregate of both Commonwealth and state or territory NHR funding and payments for block funding which is transacted through the state managed fund (SMF).

Total Other (Pool) represents other funding and payments, which are transacted through the state pool account, including public health funding, overdeposits, cross border funding and payments, and interest.

State and territory cross border payments can either be:

Paid to the relevant state or territory's local hospital networks - included within ABF and/or block payments in the above table, or

Reimbursed to the relevant state or territory where the state or territory's local hospital networks are already being funded for the cost of treating cross-border patients - shown in the Cross border payment row under Other in the above table.

Cross border funding arrangements between states and territories are yet to be put in place for state and territory contributions.

NHR funding and payments shown in these tables include GST where applicable.

A local hospital network (LHN) is an organisation that provides public hospital services in accordance with the National Health Reform Agreement. A local hospital network can contain one or more hospitals, and is usually defined as a business group, geographical area or community. Every Australian public hospital is part of a local hospital network.

NHR payments in this table are GST exclusive to enable comparability of NHR payments in each local hospital network report.

Note: The majority of government funding to local hospital networks is not subject to GST. However in some cases hospital funding to non-government entities does attract GST, for example, denominational hospitals, privately and commercially owned health facilities, or any other non-government third party provider of health services or related supplies.

Estimated monthly, YTD and annual NWAU by LHN

This table shows estimated state or territory hospital activity for activity based funding services expressed as National Weighted Activity Units (NWAU) for February 2013, the associated cumulative year-to-date (YTD) and total annual estimated NWAU for each local hospital network in the Australian Capital Territory.

NHR funding amounts and service volumes are provided by states and territories as service estimates at the start of each financial year, and may continue to be refined during the course of the year. These estimates form the basis of monthly reporting of service volumes until actual service numbers become available.

The estimated annual NWAU for each local hospital network (LHN) was provided to the Administrator as a basis for determining the Commonwealth NHR activity based funding. Current month NWAU estimates accumulate through the year-to-date NWAU to equal the annual NWAU at the end of the financial year.

An NWAU is a measure of health service activity expressed as a common unit. It provides a way of comparing and valuing each public hospital service, whether they are admissions, emergency department presentations or outpatient episodes, by weighting them for their clinical complexity. The average hospital service is worth one NWAU - the most intensive and expensive activities are worth multiple NWAU, the simplest and least expensive are worth fractions of an NWAU.

Monthly NHR payments relate to the cash needs of public hospitals and do not necessarily reflect the volume of services to be delivered in the month.